Last month, we reported that it appeared as if the quest for lower drug prices was progressing in a positive direction. As far as sticker prices go, January 2019 appeared to have the lowest number of brand drug price increases and those increases experienced the lowest aggregate rate of growth in five years as well. Less increases and smaller increases.

Now, with February’s data in the books, things still look as though they are trending in the right direction. The only surprise this month was the relatively late price updates from Eli Lilly, which accounted for 13 increases last month, averaging 4% per increase. While this is a relatively modest year for Lilly price increases, it accounted for roughly a third of all increases last month.

As we played around with this dashboard, we started digging into some anomalies we had been noticing on generic Prilosec OTC tablets (Omeprazole 20 mg Tablets), especially in Ohio Medicaid managed care.

As an over-the-counter medication, we were surprised when we saw massive charges to the state on the drug, especially when it could be regularly purchased without insurance for $15 off the shelf. Yet we noticed that Ohio Medicaid was being charged an average markup of $153 for each prescription dispensed in their PBM-controlled managed care pharmacy program.

What happened was that the dashboard showed that Major Pharmaceuticals had been rapidly gaining market share in Ohio’s Medicaid managed care program, despite being significantly overpriced when compared to other manufacturers of the drug. You can read about our inquiry here.

Well, like much of our work at 46brooklyn, our inquiry into Omeprazole tablets was enlightening but incomplete. And rather than accept a story without an ending, Coldwell and the good folks at Baird took the ball and ran with it, and boy, did they add some interesting detail into the mix.

To learn more about the interesting intermingled relationships and unhealthy incentives that have resulted in millions of dollars of overcharges in state Medicaid programs on just this one drug, check out the Columbus Dispatch’s deep-dive into the issue, complete with commentary from Coldwell and your friends at 46brooklyn.

“And about ‘these ridiculously priced tablets,’ Coldwell questioned: ‘If CVS doesn’t have any control over the items that they claim not to control, then why are we (taxpayers) paying them so handsomely?’”

With Eli Lilly announcing plans to launch a generic version of Humalog, 46brooklyn’s Antonio Ciaccia discussed the complexity of the drug supply chain and its impact on list prices with Shari Rudavsky at the Indianapolis Star.